Healthcare Provider Details

I. General information

NPI: 1891701678
Provider Name (Legal Business Name): KERRY CHRISTIAN BUHK PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5965 RENAISSANCE PL
TOLEDO OH
43623-4709
US

IV. Provider business mailing address

5965 RENAISSANCE PL
TOLEDO OH
43623-4709
US

V. Phone/Fax

Practice location:
  • Phone: 419-882-5678
  • Fax: 419-882-7446
Mailing address:
  • Phone: 419-882-5678
  • Fax: 419-882-7446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number4465
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: